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Blister
Aka: Blister, Vesiculobullous, Vesiculobullous Rash, Vesicle, Bulla, Bullous Disease, Bullous Condition, Autoimmune Bullous Dermatoses, Acantholysis, Acantholytic- Definitions
- Vesicle
- Raised fluid filled lesion <0.5 cm diameter
- Bulla
- Raised fluid filled lesion >0.5 cm diameter
- Vesicle
- Pathophysiology
- Develops at intersection of skin levels
- Epidermal layers
- Epidermal-Dermal junction (Deeper lesions)
- Develops at intersection of skin levels
- Types
- Subcorneal Vesicle or bulla
- Occurs immediately below Stratum Corneum
- Examples
- Spongiosis (e.g. Allergic Contact Dermatitis)
- Intracellular edema in epidermal layers
- Acantholysis
- Occurs in all forms of Pemphigus
- Desmosomes (intracellular bridges) disrupted
- Results in loss of Keratinocyte cohesion
- Acatholytic cells become rounded (from polyhedral)
- Viral induced cell destruction (e.g. Varicella)
- Epidermal cells expand as they degenerate
- Subcorneal Vesicle or bulla
- Signs
- Thin, translucent walls
- Contains serum, lymph, blood, or extracellular fluid
- Nikolsky's Sign
- Evaluation: Acute Blistering Condition
- Consider Exposures
- Insects
- Pets
- Medications (e.g. Drug-Induced Bullous Disease)
- Contact Dermatitis allergens and irritants
- Infection (e.g. Bullous Impetigo)
- Consider Trauma
- Burn
- Friction injury
- Observe for mucosal lesions
- Consider systemic causes
- Diabetes Mellitus
- Systemic Lupus Erythematosus
- Thyroid disease
- Porphyria
- Celiac Sprue
- Consider Exposures
- Labs
- Tzanck Smear and viral culture
- Indicated for grouped herpetiform Vesicles
- Biopsy with Immunofluorescence
- Indicated for bullae in older patients
- Rule-out Pemphigus or Pemphigoid
- Tzanck Smear and viral culture
- Differential Diagnosis: Vesicle or Bulla Depth
- Superficial Vesiculobullous Conditions (Intraepidermal)
- Deep Vesiculobullous Conditions (Dermal-Epidermal)
- Pemphigoid (e.g. Bullous Pemphigoid)
- Dermatitis Herpetiformis
- Erythema Multiforme
- Porphyria cutanea tarda
- Diabetes Mellitus associated bullae
- Renal disease associated bullae
- Differential Diagnosis: Bullous Lesions
- Autoimmune
- Other Bullous Conditions
- Differential Diagnosis: Vesicular Lesions
- Drug eruption (e.g. Drug-Induced Bullous Disease)
- Atopic Dermatitis
- Contact Dermatitis
- Erythema Multiforme
- Herpes Simplex Virus
- Herpes Zoster
- Scabies
- Cat Scratch Disease
- Varicela Zoster Virus
- Dermatitis Herpetiformis
- Lichen Planus
- Porphyria cutania tarda
- References
- Goldman (2000) Cecil Medicine, p. 2283
- Habif (1996) Dermatology, Mosby-Year, p. 9-10
- Rye (1997) Am Fam Physician 55(8):2709-18 [PubMed]
Acantholysis (C0000887) |
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Definition (MSH) | Separation of the prickle cells of the stratum spinosum of the epidermis, resulting in atrophy of the prickle cell layer. It is seen in diseases such as pemphigus vulgaris (see PEMPHIGUS) and DARIER DISEASE. |
Concepts | Pathologic Function (T046) |
MSH | D000051 |
SnomedCT | 43327007 |
English | Acantholyses, Acantholysis, Acantholysis [Disease/Finding], acantholysis, Acantholysis (morphologic abnormality) |
Japanese | 棘融解, キョクユウカイ |
Swedish | Akantolys |
Czech | akantolýza, Akantolýza |
Finnish | Akantolyysi |
Russian | AKANTOLIZ, АКАНТОЛИЗ |
Polish | Akantoliza |
Hungarian | Acantholysis |
Norwegian | Akantolyse |
Spanish | acantólisis (anomalía morfológica), acantólisis, Acantolisis, Acantólisis |
Dutch | acantholyse, Abces, Acantholysis |
French | Acantholyse |
German | Akantholyse |
Italian | Acantolisi |
Portuguese | Acantólise |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Bulla (C0005758) |
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Definition (MSHCZE) | Viditelné nahromadění tekutiny uvnitř nebo pod pokožkou. |
Definition (SCTSPA) | Lesión sobreelevada, llena de líquido, generalmente translúcida, mayor de 1 cm de diámetro |
Definition (SNOMEDCT_US) | A fluid-filled, raised, often translucent lesion, greater than 1 cm in diameter |
Definition (NCI) | A large (greater than 5-10 mm) intraepidermal/subepidermal cavity filled with clear, serosanguineous or cloudy fluid. |
Definition (NCI) | An intraepidermal/subepidermal cavity filled with clear, serosanguineous or cloudy fluid.(NICHD) |
Definition (NCI_NCI-GLOSS) | A fluid-filled sac in the outer layer of skin. It can be caused by rubbing, heat, or diseases of the skin. |
Definition (CSP) | visible accumulations of fluid within or beneath the epidermis. |
Definition (MSH) | Visible accumulations of fluid within or beneath the epidermis. |
Concepts | Pathologic Function (T046) |
MSH | D001768 |
SnomedCT | 287129000, 271208000, 210984001, 339008, 247464001 |
English | Bleb, Blister, Bulla, Bullae, Vesication, Vesications, Blebs, BLISTERS, Blistering eruption, Blister NOS, bulla, vesication, blister, blister (diagnosis), Bullous lesions, Blister [Disease/Finding], bullous lesions, bullous lesion, bullae, Bullous Lesion, Bullous Lesions, Lesion, Bullous, Lesions, Bullous, Blister NOS (disorder), Blister: NOS, Blisters, Blistering, Blister (morphologic abnormality), Blister, NOS |
Dutch | bulleuze laesies, blaren, bullae, blaarvorming, blaar, Blaar, Bulla, Vesica |
French | Ampoules, Bulles, Lésions bulleuses, Vésication, VESICULES, Vésicule cutanée, Phlyctène, Vésicule, Bulle, Ampoule, Cloque, Lésion bulleuse |
German | Blasen, Bullae, blasige Laesionen, BLAESCHENAUSSCHLAG, Blasenbildung, Blase, Bulla |
Italian | Lesioni bollose, Vescicole, Vescicolazione, Bolle, Lesione bollosa, Vescicazione, Bolla, Vescichetta, Vescicola |
Portuguese | Formação de bolhas, Lesões bolhosas, Ampolas, VESICULAS, Bolhas, Bolha, Vesícula |
Spanish | Lesiones ampollosas, Vesiculación, AMPOLLAS, Bulla, ampolla, SAI, ampolla, SAI (trastorno), Ampolla, Ampollas, Bullas, ampolla (anomalía morfológica), ampolla, flictena (trastorno), flictena, ampolla filtrante (anomalía morfológica), ampolla filtrante, Vesicación, Vesícula |
Japanese | 皮膚水疱, 水疱性病変, 水疱形成, ヒフスイホウ, スイホウ, スイホウセイビョウヘン, スイホウケイセイ, 水疱, 発疱疹, ブラ |
Swedish | Blåsa |
Czech | puchýř, Bulózní léze, Puchýř, Buly, Puchýřnatění, Puchýře, bula, bulla |
Finnish | Rakkula |
Russian | VOLDYR', BULLA, PUZYREK, БУЛЛА, ВОЛДЫРЬ, ПУЗЫРЕК |
Polish | Pęcherz, Pęcherz skórny, Pęcherz śluzówkowy, Pęcherze |
Hungarian | Hólyag, Bullosus laesiók, Hólyagosodó, Bullák, Hólyagok |
Norwegian | Blemme, Vable, Vesikkel, Blære, Bulla, Bulløs skade, Gnagsår |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Skin Diseases, Vesiculobullous (C0037275) |
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Definition (MSH) | Skin diseases characterized by local or general distributions of blisters. They are classified according to the site and mode of blister formation. Lesions can appear spontaneously or be precipitated by infection, trauma, or sunlight. Etiologies include immunologic and genetic factors. (From Scientific American Medicine, 1990) |
Concepts | Disease or Syndrome (T047) |
MSH | D012872 |
English | Dermatoses, Vesiculobullous, Skin Disease, Vesiculobullous, Skin Diseases, Vesiculobullous, Vesiculobullous Dermatoses, Vesiculobullous Skin Disease, Vesiculobullous Skin Diseases, SKIN DIS VESICULOBULLOUS, VESICULOBULLOUS SKIN DIS, Skin Diseases, Vesiculobullous [Disease/Finding] |
Swedish | Hudsjukdomar, vesikulobullösa |
Czech | kůže - nemoci bulózní |
Finnish | Rakkulaihotaudit |
Russian | PUZYRNYE DERMATOZY, SNEDDONA-UILKINSONA SINDROM, KOZHNYE BOLEZNI VEZIKULIARNYE, DERMATOZY PUZYRCHATYE, SUBKORNEAL'NYI PUSTULEZ, DERMATOZ PUSTULEZNYI SUBKORNEAL'NYI, ДЕРМАТОЗ ПУСТУЛЕЗНЫЙ СУБКОРНЕАЛЬНЫЙ, ДЕРМАТОЗЫ ПУЗЫРЧАТЫЕ, КОЖНЫЕ БОЛЕЗНИ ВЕЗИКУЛЯРНЫЕ, ПУЗЫРНЫЕ ДЕРМАТОЗЫ, СНЕДДОНА-УИЛКИНСОНА СИНДРОМ, СУБКОРНЕАЛЬНЫЙ ПУСТУЛЕЗ |
Japanese | 角層下膿疱症, スネドン・ウィルキンソン病, 皮膚疾患-水疱性, スネドン-ウィルキンソン病, 水疱性皮膚疾患, 小胞水疱性皮膚疾患, 膿疱症-角層下, Sneddon-Wilkinson病, 皮膚疾患-小胞水疱性 |
Spanish | Dermatopatías Vesiculoampollosas, Enfermedades Cutáneas Vesiculoampollosas, Dermatopatías Vesiculobullosas, Enfermedades Ampollosas de la Piel, Dermatopatías Bullosas, Dermatopatías Bulosas, Enfermedades Bullosas de la Piel |
Italian | Dermatosi vescicolobollosa, Malattie vescicolobollose della pelle |
Croatian | Not Translated[Skin Diseases, Vesiculobullous] |
Polish | Choroby skóry pęcherzowe |
Norwegian | Vesikulobulløse dermatoser, Vesikulobulløse hudsykdommer, Vesikulobulløse utslett |
French | Dermatoses vésiculo-bulleuses, Dermatoses vésiculobulleuses |
German | Hautkrankheiten, vesikulobullöse, Vesikulobullöse Hautkrankheiten |
Dutch | Huidziekte, vesiculobulleuze, Huidziekten, vesiculobulleuze, Vesiculobulleuze huidziekte, Vesiculobulleuze huidziekten |
Portuguese | Dermatopatias Vesiculobolhosas |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Vesiculobullous rash (C0151883) |
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Concepts | Finding (T033) |
SnomedCT | 14912003 |
English | VESICULOBULLOUS RASH, VESICULOPUSTULAR RASH, Vesiculo-bullous eruption, Rash vesiculo-bullous, Vesiculo-bullous rash, Rash vesiculobullous, Vesiculo-pustular rash, Rash vesiculopustular, Rash vesiculo-pustular, Vesiculopustular rash, Vesiculobullous rash, Vesiculobullous rash (morphologic abnormality) |
Dutch | vesiculobulleuze rash, vesiculobulleuze uitslag, vesiculobulleuze eruptie, rash vesiculopustulair, vesiculo-pustulaire rash |
French | Rash vésiculo-bulleux, Rash vésiculobulleux, Eruption vésiculobulleuse, ERUPTION VESICULO BULLEUSE, ERUPTION VESICULO PUSTULEUSE, Rash vésiculo-pustulaire, Rash vésiculopustuleux |
German | Ausschlag vesikulo-bulloes, vesikulo-bulloeser Ausschlag, vesikulobulloeser Ausschlag, Ausschlag vesikulobulloes, EXANTHEM VESICULOBULLOES, EXANTHEM VESIKULOPUSTULOES, vesikulo-pustuloeser Ausschlag, Ausschlag vesikulo-pustuloes, Ausschlag, vesikulo-pustuloes |
Italian | Eruzione vescico-bollosa, Esantema vescicolo-bolloso, Esantema vescicolo-pustoloso, Eruzione vescico-pustolosa |
Portuguese | Exantema vesiculobolhoso, Erupção vesiculobolhosa, ERUPCAO VESICO-BOLHOSA, ERUPCAO VESICO-PUSTULOSA, Exantema vesiculopustuloso, Erupção vesiculopustulosa |
Spanish | Erupción vesiculoampollar, Erupción vesicoampollar, ERUPCION VESICULOAMPOLLOSA, ERUPCION VESICULOPUSTULAR, Erupción vesiculopustular, Erupción vesicopustular, erupción vesicoampollosa (anomalía morfológica), erupción vesicoampollosa, rash vesicoampolloso, salpullido vesicoampolloso, sarpullido vesicoampolloso |
Japanese | 小水疱水疱性皮疹, 小胞水疱性皮疹, ショウホウスイホウセイヒシン, ショウスイホウスイホウセイヒシン, 水疱膿疱性皮疹, スイホウノウホウセイヒシン |
Czech | Vezikulobulózní výsev, Vezikulobulózní erupce, Vezikulobulózní vyrážka, Vezikulopustulózní vyrážka |
Hungarian | Apró- és nagyhólyagos kiütés, Kiütés vesiculo-pustulosus, Vesiculo-pustulosus exanthema, exanthema vesiculo-bullosa, Vesiculo-pustulosus kiütés, vesiculobullosus kiütés, Kiütés, vesiculo-bullosus, exanthema vesiculo-pustulosa, vesiculo-bullosus kiütés |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Vesicle (morphologic abnormality) (C0333262) |
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Definition (CHV) | a small liquid filled sac |
Definition (CHV) | a small liquid filled sac |
Definition (SCTSPA) | Lesión pequeña (de menos de 1 cm de diámetro) llena de líquido, sobreelevada con respecto al plano de la piel circundante |
Definition (SNOMEDCT_US) | A small (less than 1 cm) fluid-filled lesion, raised above the plane of surrounding skin |
Concepts | Acquired Abnormality (T020) |
SnomedCT | 82515000 |
English | vesicle, vesicles, Vesicle formation, Vesicle, Vesicle (morphologic abnormality) |
Spanish | vesícula (anomalía morfológica), vesícula |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Acantholytic (C0443130) |
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Concepts | Qualitative Concept (T080) |
SnomedCT | 263655009 |
English | acantholytic, Acantholytic, Acantholytic (qualifier value) |
Spanish | acantolítico (calificador), acantolítico |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Bullous conditions (C0851664) |
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Concepts | Disease or Syndrome (T047) |
Italian | Condizioni bollose |
Japanese | 水疱形成, スイホウケイセイ |
Czech | Bulózní stavy |
English | Bullous conditions |
Hungarian | Bullózus állapotok |
Portuguese | Patologias bolhosas |
Spanish | Enfermedades ampollosas |
Dutch | blaarvormingen |
French | Affections bulleuses |
German | Blasige Erkrankungen |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
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